Individual
CHAN JEROME PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
7190 S CIMARRON RD, LAS VEGAS, NV 89113-2171
(702) 675-3240
(702) 982-6347
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
20992
NV
Other
Enumeration date
03/31/2011
Last updated
10/30/2024
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